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This month I would like to bring the fabulous DUTCH test into focus. acronym for; Dry Urine Test For Comprehensive Hormones

If you think you have issues with chronic stress, that is affecting your hormones then this is the test for you to complete.  Like most private LAB tests it can be done in the privacy of your home, taking only minutes to complete.

MARKERS CONSIDERED IN THE DUTCH TEST

SAMPLE REPORT

Stress

The definition of STRESS is the down-regulation of the HPA axis. Down-regulating the para-sympathetic nervous system, creating a dominant sympathetic response.

What happens when we get stressed? We release cortisol, taking 10 minutes to release, but then between 1-2 hour to break down.  This can vary however depending on the health of the individual since the liver is involved within the process of breaking down cortisol when liver issues are present it can take 3-4 hours or even all day to break down.

Cortisol is then affected by the balance of all other hormones in your body. The Dutch test is a highly sensitive test, bringing all hormones into focus when considering your stress hormones.  See the sample report above.

Cortisol is bound up by cortisol binding globulin transcortin.  Transcortin is very sensitive to estrogen.  Actually, all binding globulins are sensitive to estrogen.  Therefore, when a woman is on the contraceptive Pill, or has been on the Pill for some time, there is a very good chance she is low in FREE cortisol, simply because it is all bound up to the binding globulins.

Free cortisol is less than 5% circulating but in its active form.


SEX HORMONES

 

DHEA

  • DHEA, 80% is made in the adrenal glands 20% in the ovaries.
  • DHEAs is what is measured, however, this is not the active form.  DHEA needs to un-S taking the S off to become the active form. This conversation is dependent on the SULT1A1 gene, therefore sulphonation plays a role.
  • DHEA is your master hormone, breaking down to the three estrogens.
  • If you’ve had your 23&Me interpreted, you can check to see the status of your SULT genes.
  • DHEA made in the brain protects the hippocampus from cortisol, therefore DHEA in the brain is a good thing.
  • Stress damages our hippocampus, affecting our short term memory, not good!

Cortisol

When we get too much free cortisol roaming the system, our receptor sensitivity stopping being so active. Adrenaline and cortisol end up circulating.  In this way, chronic stress leads us into a rut, in which the wiring of our neural networks keeps us repeating the same dysfunctional behaviour.  Yet hoping for a different outcome! This by definition, is a form of insanity.


Adrenal Medulla

Other genes which are relevant to our stress response, mood and thinking are the COMT and MAOA. When these are running slow, you will not be breaking down catecholamines easily, and therefore do not break adrenaline down easily either. Check these genes if you are feeling stressed all day! Running slow means a high amount of neurotransmitters are stored since you are not going to break down adrenaline or nora-adrenaline.  Rather, it can carry on ALL day.  Stressy, buzzy, tense.

All there needs to be present to impact this system significantly is an infection, inflammation, food intolerance or a pile of housework building up to tip someone with slow genes to be tipped into overwhelm.

Cerebral cortex > CRH > anterior pituitary > ACTH > cortisol release > adrenaline and noradrenaline.

Our protective, survival mechanism is to shut down the parasympathetic nervous system and upregulate the sympathetic, now we are chronically in fight and flight! At this stage, we are likely to get receptor sensitivity. We can liken this to ‘annoying kid syndrome’ which I use to call being ‘mummed’.  Mum, mum, mum .. for hours.  We then get hyper-sensitive, and cortisol goes up even further because we are not tolerating it.

On the other hand, if you are a super laid back person your COMT and/or MAOA may be running too quickly.  Feed the furnace with additional protein plus Tyrosine.


How do we break the cycle? 

Change the biochemistry through food and nutrient therapy and then also rewire your habits.

Two analogies work for me here:  First, we need to dry up the riverbeds were ‘too much’ of a hormone/catecholamine/ transmitter has been allowed to flood the system. Secondly, it takes a while for a worn-down path to grow grass again, was ‘not enough’ of the right hormone/catecholamine/transmitter has been present.


Stress and Fasting

Clients like to bring in the option of fasting, believing that fasting will help to clear the system and take the stress of the system.  Whilst this is true in cases where adrenal fatigue is NOT present, it is not true for those who do not have a robust HPA axis. Primarily cortisol manages blood sugar levels. Do not stress the system out even more by Fasting when adrenal dysregulation is present.


Auto-immunity

Cortisol is higher in the morning with the sun. When cortisol is high it suppresses melatonin and growth hormone production.  Cortisol helps to fight infection via inflammation, think viruses, bacteria, etc.  The pro-inflammatory cytokines stimulate the stress system releasing cortisol.

There is real importance in this morning cortisol spike.  When auto-immune symptoms are presented then understanding your cortisol patterns is super important.  Low cortisol in the morning means that the auto-immune regulator does not happen.  Morning cortisol triggers those cells in the thymus who failed central tolerance to get destroyed.  What that means is, before immune cells get let out into the body, the thymus checks whether immune cells are auto-immune.  If cells are auto-immune, then the thymus pushes the cells off to the side and the thymes kill those cells.  Without the morning spike THIS DOES NOT HAPPEN!, and auto-immune cells get let out into the system.

Therefore, if we are consuming foods which create a cortisol spike at night, or we are fighting an infection at night, this suppresses melatonin, which in turn stops us from sleeping.  Leads to a low cortisol spike in the morning with auto-immune flare-ups.  For this reason, gluten and HHV6 will play more than one roll in creating auto-immune flare-ups.


GET YOURSELF TESTED

 

When is it best time to test?

  • 5-7 days after ovulation on days 19, 20, 21
  • If your cycles are long, then shift up. If your cycles are short, then shift down.
  • First, track your ovulation through temperature gauging or other symptoms.  Then count forward by 5-7 days and collect your urine.

Look at your Estrogens

Dutch tests for Estrogens E1 E2 E3, which then go through the liver and get converted to Hydroxy 2, Hydroxy 4 or Hydroxy 16.

Each esterogen dominant pathway has key characteristics. Estrogen 4 hydroxy for instance goes down the quinone pathway, correcting to estrogen-related cancers.

16 Hydroxy, the 2/16 ratio 2:16 can implicate estrogen proliferative symptoms such as moody, PMS, tender breasts and weight gain.

2 Hydroxy is The Happy Healthy Way.

Estrogen in the right amount

Good for > bone health

Good for > brain cognition

Good for > temperature regulation

Good for > collagen, tissue skin

Good for > fertility

When it’s decreased, we can face menopausal symptoms, skipping of cycles, low cholesterol even anorexia!

Too much estrogen, pre-disposed from either being on the contraceptive pill, environmental estrogens such as cling wrap, tap water (re-cycling of the hormone pill within the water system:

We can experience being over-weight, diabetes, increased risk of Alzheimer, PCOS.

Reduced hormones, on the other hand, can be a direct result from cholesterol-reducing medication for instance. People seem to over-look that cholesterol makes up all our hormones.  When we lower cholesterol we also lower our testosterone, DHEA and Estrogens.


Other estrogen lowering activities

  • Extreme exercise, marathon running, cross-fit.
  • Frequent flying
  • Under appropriate body weight.
  • Head injuries.
  • Surgery decreases the blood flow to the area as capillaries are damaged.
  • Sugar, gums up the works, diabetes, and smoking.
  • Birth control pill reduces estrogen in the long term.

Consider Progesterone

Progesterone helps with anxiety and insomnia as well as the lining of the uterus, as women losing progesterone report anxiety and insomnia.

Alpha-pregnanediol goes down, usually goes up to GABA, supporting the glymphatic system during sleep.

A-pregnanediol typically converts into neuro-steroid ALLO, that crosses BBB (blood brain barrier) and can activate GABA a-receptors.

Progesterone in the brain is calming, supporting neurons, and is even used after traumatic brain surgery or after Stroke.

Progesterone enhances serotonin receptors in the brain and reduces gall bladder activity. Conversely, higher estrogen increases the risk of gall bladder disease and stones.

Those on lots of NSAIDS will typically have low progesterone activity when used for more than 10 days.


Consider Androgens

DHEA: facial hair, acne


Consider FREE cortisol, verses stored cortisol

  • Consider infections
  • Consider allergies
  • Consider food intolerances
  • Consider weight gain

Marker 8-hydroxy-2-deoguanosine (8OHdG)

Marker correlating to chronic inflammation, high stress, high cortisol, insomnia, hypertension, kidney disease, IBD, depression.


What do we do now with this information?

Note where on the dials we are, which is dominant. Are we triple estrogen dominant?

Depending on where your markers are, we may wish to support Phase 1 liver with P450 enzymes and DIM. Or Phase 2 Liver with SamE precursor or SamE if you wish to order it in from the US.  P%P, Mg, Choline, Methionine, Methyl groups TMG are all useful here.

Foods can be influential, but ONLY if stomach acid is good.  This will not be the case where P5P and/or TMG is warranted. Kale, broccoli, Brussel Sprouts, Broccoli Sprouts, artichoke, onions, foods high in FOS and fibre.

Support Glymphatic system for catecholamine clearance at night.

Support MAOA with SamE donations and methyl donors.

Support COMT with Mg chloride.

Support the serotonin pathway.

Support the dopamine pathway.

Harness the benefits of apoptogenic herbs.

Combat infections.

Temper exercise according to the dominant hormone, verses hormone insufficiency.

Support HPA axis with key nutrients; C, B5, Zn, Fe, Mg, Sel

Weight management.

Given the results of your DUTCH test, there are plentiful options to improve your health.  So, if you are interested in ordering this test with result interpretation you can email Anna directly.

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Are we only as healthy as … How Well We Eliminate Waste … from our bodies?

Detoxification is critical to the success or every healing program.  Since we are bombarded by environmental intoxicants 24/7 both from inside our homes, to the products we lather onto our skin, the food we eat and the air we breathe. Our bodies play host to an accumulation of herbicides, heavy metals, xeno-estrogens, all of which can be a big part in why those with chronic health issues are chronically ill. 

What I and other nutritionists/naturopathic physicians have found, is the strong correlation between those who are most sick and those who have had the most significant exposures, and are unable to detoxify so well.

Therefore, I believe educating ourselves about environmental toxins is critical.  And this can then translate into making better choices for our health, the health of our families, and it helps our planet also. Why? Because the substances that are hurting our bodies, by and large, affect our planet through climate change too. 

I consider toxins to be the number underlying causes of chronic diseases today, but sadly the doctors are NOT looking for this. It is my firm belief that when people are sick there is ALWAYS an underlying root cause.

Download your HOME DETOX GUIDE


Heavy metals and the brain

We also have a great deal of science and a strong correlation between the toxic loading of certain heavy metals and neuro-degenerative diseases.  Therefore keeping our brains as well as bodies free from toxic levels of heavy metals is paramount when supporting neurological health 

It’s hard to know exactly what heavy metal content exists within each of our brains unless we dissect the actual brain after passing.  However, we are able to measure heavy metal burden released into the urine when challenged by a sulphur donation agent.   Signifying theoretical total body burden in terms of reasonable or unreasonable levels excreted via this drainage pathway when challenged.  (The DMSA Challenge Test has been mentioned within a previous post.) 

But firstly let’s talk about the Glymphatic System and what we do know about how this protects our brain. The glymphatic system was only recently discovered within the University of Virginia in the US.


What is the Glymphatic System?

The Glymphatic System clears metabolic waste from the brain.  It does this at night during the hours when we are asleep.   First, at night the brain shrinks by 60% of its size in order to make room for the flow of the lymph (Glymphatic System) around it. 

Lymph flows along the arteries, bathing our neurons with nutrients whilst removing metabolic waste and then flows along the veins before exiting.  A vital system for health which is protected by good amounts of sleep each night.  

Unfortunately, not everyone has a healthy functioning Gymphatic System. As it is easily compromised when challenged by toxicity such as heavy metals, but brain injuries can also damage this system. 

Clearly, a damaged Glymphatic System can become a chicken and egg scenario since heavy metals damage the Glymphatic System, which in turn a compromises our ability to detoxify heavy metals.

If an individual is predisposed to carrying an increased toxicity load of heavy metals, predisposed by their genetic makeup, and then experiences a brain injury this can be a very tough situation indeed.  When this set up arises, every attempt to live a clean life, integrating detoxification techniques on a regular basis with good quality sleep also critical to this cleansing system.  Since we know that brain injuries incur an increased risk of neurological issues.


LEAD & GABA

We know that lead can be stored in the bone, as lead diametrically opposes calcium and therefore increments bone loss (post to follow), but it also interferes in our GABA production too.  As a result, a chemical known as Amyloid Beta accumulates when the Glymphatic system is not working well, causing incremental neuro-degeneration.

GABA regulates how well the lymph can flow in and out of the brain.  Therefore it is critical to our cleansing system.


Mercury

Exposure to mercury in the mouth also has negative effects on the Glymphatic system. Over time the vapour gets taken up into the brain from the mouth.  There is a retrograde effect as it gets into the nerves, and then to the brain, damaging astrocytes.  This can be an appalling insult to the Glymphatic system and its optimal functioning.


Sleep

When facing toxicity challenges sleep becomes all the more important. Sleep is therefore paramount in terms of reducing susceptibility to all neurodegenerative conditions.   We absolutely need to sleep in order for this system to work. Melatonin is produced by the pineal gland, secreted to help us have a restful deep sleep. But it also helps to cleanse our brains. I love to take a slow-releasing or sub-lingual form of melatonin before I sleep.  It is neuroprotective anti-oxidant clearing mercury, lead, viruses, etc from the brain.


Melatonin

Taking a step back, think about why we may have reduced melatonin?

Legally, we are not allowed to sell/buy melatonin in the UK, therefore apart from purchasing it from our US friends overseas, let’s look at what else can we do to support our melatonin levels naturally. 

Our love of technology exposes us to un-natural amounts of blue light from our phones and ipads, laptops, etc.  Blue light is the same as sunlight, which inhibits melatonin production. 

Realistically, we need to minimise blue-light once the sun goes down.  To support this there are screensavers with blue light blocker and amber glasses which also block out blue light.  By reducing blue-light after sun-down we are naturally supporting our bodies to produce melatonin in the way it is meant to.

Melatonin in pill form

Melatonin in pill form is sold readily in the US, but as mentioned not legally in the UK.  There are brands however that will ship overseas. Source Naturals and Allergy Research for instance.

Pills will need to be processed by the liver and the digestive tract before it is absorbed.  Which works for some people, but for those who are sick, this is not ideal, since they typically have compromised digestion.

Liposomal Melatonin is bound up with phosphatidyl choline. Phos choline is an essential-fat that our brains are made up of.  Therefore this is the perfect delivery system, we can harness this to get melatonin into our system and therefore brain more readily.


Setting the Bedroom Environment

  • The bedroom should ideally be EMF free. Meaning that all electronics need to be outside the bedroom.
  • Install Blackout blinds or shutters.
  • Keep the bedroom free from glues, hairsprays, and hormone-altering chemicals

Consider using Liposomal GABA and Liposomal Melatonin prior to sleeping, to support Glymphatic cleansing.


The Anti-Diuretic-Hormone (ADH)

Those with high mercury content in their bodies often have ADH (90%).  Which can be lowered easily with a drug provided from your GP.  Although I am not a huge fan of pharmacology, there is a place for using some drugs in the short term.

Those with high levels of ADH wake up in need of a pee.  The second point is to address electrolytes. Recommended products for this: E-Lyte from Allergy Research, Ocean 72 from Concentrace, and Crystal Energy from Patrick Flanigan.

Then, take a look at what is down-stream from the brain.  Do you get chronic sinusitis? And/or tonsillitis? There may have been a history of chronic Strepp?

When tonsils are removed, this leaves scars, causing stress on the nerve centre which is the Superior Sympathetic Ganglian.  The Superior Sympathetic Ganglian regulates blood flow to the pineal. Which if scarred can lead to chronic insomnia due to an interruption of blood flow both to and from the brain.


Taking it one step further

It is one thing to identify whether you have a heavy metal burden, but quite another to be Sensitive to Heavy Metals!’

This can happen too!

Our immune systems are now literally reacting to heavy metals. What this means is that not only our total body burden is an issue, but that our immune system now reacts to even the tiniest amount.  We are now hyper-sensitive to metals and therefore have an allergy.

This is a type 4 allergic reaction. When T-Lymphocites recognise and allergenic molecule in our system causing inflammation.

Common metal allergens are nickel, gold, mercury, and titanium.  Typically those who are allergic to nickel cannot wear it within their jewellery.  Nickel is within a lot of dental work, usually the origin of such an allergy.

There is various testing that can be completed to assess allergenic responses to metals.  I prefer to use Cyrex Array 11  Chemical Immune Reactivity Screen.

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